Medical management of orbital myocysticercosis: a pilot study

To evaluate the efficacy of albendazole in the management of orbital myocysticercosis.

Twenty-one consecutive patients diagnosed as having orbital myocysticercosis by ultrasonography, supported by computed tomography (CT)/magnetic resonance imaging (MRI), were included in the study. All patients received oral albendazole at a dosage of 30 mg/kg for 15 days with a low-dose steroid cover (5-10 mg per day). The patients were followed on day 2 at 2 weeks, 1 month, 3 months, 6 months and 9 months, and finally at 1 year. Orbital sonography was performed at 2 weeks, 3 months, 6 months, 9 months and 1 year. CT scan was performed at 6 months and 1 year.

Orbital sonography revealed a well-defined cystic lesion with clear contents and a hyperechoic area suggestive of a scolex in all the patients. CT or MRI provided additional supportive evidence. The size of the cysts measured before treatment ranged from 6.2 to 13.4 mm (mean 11.4 mm). Medial rectus was involved in 10 cases, superior rectus in 7 cases and lateral rectus in 4 cases. Serial ultrasonography revealed a gradual reduction in the cyst size in 20 patients. A mild obscuration of the cyst wall, followed by collapse of the cyst cavity and obscuration of the scolex, were progressively seen as the cyst reduced in size. Complete resolution of the cyst was seen in all cases at 6 months. A CT scan performed at 1 year supported the ultrasonographic findings. No systemic side effects were noted.

Oral albendazole appears to be highly efficacious in the management of orbital myocysticercosis.